Prolactin in afya

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Prolactin is secreted by anterior pituitary controlled by a wide variety of physiological factors. 
Dopamine acts as the primary prolactin releasing inhibitory factor - dopamine agonists (bromocriptine) may be used to control galactorrhoea. 
Must differentiate galactorrhoea (due to the actions of prolactin on breast tissue) from gynaecomastia

''Features of excess prolactin''
    men: impotence, loss of libido, galactorrhoea
    women: amenorrhoea, galactorrhoea

''Causes of raised prolactin'' PPPPPP
    prolactinoma
    pregnancy - oestrogens
    physiological: stress, exercise, sleep
    polycystic ovarian syndrome
    primary hypothyroidism (due to thyrotrophin releasing hormone (TRH) stimulating prolactin release)
acromegaly: 1/3 of patients

''Drug causes of raised prolactin'' - more PPPPPP
    metoclopramide, domperidone
    phenothiazines
    haloperidol
    very rare: SSRIs, opioids

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